Comparison between dynamic gadoxetate-enhanced MRI and 99m Tc-mebrofenin hepatobiliary scintigraphy with SPECT for quantitative assessment of liver function
F. Rassam (Universiteit van Amsterdam)
Tian Zhang (TU Delft - ImPhys/Quantitative Imaging)
K. P. Cieslak (Universiteit van Amsterdam)
C. Lavini (Universiteit van Amsterdam)
J. Stoker (Universiteit van Amsterdam)
Roel J. Bennink (Universiteit van Amsterdam)
Thomas Van Gulik (Universiteit van Amsterdam)
L.J. van Vliet (TU Delft - Applied Sciences, TU Delft - ImPhys/Quantitative Imaging)
J. H. Runge (Universiteit van Amsterdam)
F.M. Vos (TU Delft - ImPhys/Quantitative Imaging, Universiteit van Amsterdam)
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Abstract
Objectives: To compare Gd-EOB-DTPA dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) with
99m
Tc-mebrofenin hepatobiliary scintigraphy (HBS) as quantitative liver function tests for the preoperative assessment of patients undergoing liver resection. Methods: Patients undergoing liver surgery and preoperative assessment of future remnant liver (FRL) function using
99m
Tc-mebrofenin HBS were included. Patients underwent DHCE-MRI. Total liver uptake function was calculated for both modalities: mebrofenin uptake rate (MUR) and Ki respectively. The FRL was delineated with both SPECT-CT and MRI to calculate the functional share. Blood samples were taken to assess biochemical liver parameters. Results: A total of 20 patients were included. The HBS-derived MUR and the DHCE-MRI-derived mean Ki correlated strongly for both total and FRL function (Pearson r = 0.70, p = 0.001 and r = 0.89, p < 0.001 respectively). There was a strong agreement between the functional share determined with both modalities (ICC = 0.944, 95% CI 0.863–0.978, n = 20). There was a significant negative correlation between liver aminotransferases and bilirubin for both MUR and Ki. Conclusions: Assessment of liver function with DHCE-MRI is comparable with that of
99m
Tc-mebrofenin HBS and has the potential to be combined with diagnostic MRI imaging. This can therefore provide a one-stop-shop modality for the preoperative assessment of patients undergoing liver surgery. Key Points: • Quantitative assessment of liver function using hepatobiliary scintigraphy is performed in the preoperative assessment of patients undergoing liver surgery in order to prevent posthepatectomy liver failure. • Gd-EOB-DTPA dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) is an emerging method to quantify liver function and can serve as a potential alternative to hepatobiliary scintigraphy. • Assessment of liver function with dynamic gadoxetate-enhanced MRI is comparable with that of hepatobiliary scintigraphy and has the potential to be combined with diagnostic MRI imaging.
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